Pharmacy Rant Re: Eliquis - But not Entirely About Eliquis

Miscellaneous and Personal Stuff I Must Share
1

I have been prescribed Eliquis as a blood thinner since early 2023 when I experienced pulmonary embolisms subsequent to a Covid infection. This medication is insanely expensive but my local Rite Aid store was fantastic at negotiating all of the necessary protocols and everything went smoothy. I had developed a great professional relationship with one of the pharmacists and appreciated his helpful advice on many occasions.

And then Rite Aid closed this year in May 2025.

Not many options available except for a local family owned pharmacy which is actually huge and has 7 stores in the county.
Or Walmart.

I chose the local pharmacy as I’ve dealt with them off and on forever. My parents used this store since it started in the 1950s.

When I went to pick up my last refill the owner was complaining to me at the counter about my 90 day Rx but finally agreed to fill it every 30 days. I may have misunderstood this conversation because it did not make any sense to me.

This week I required a new prescription and had my hematology clinic send the Rx to the local pharmacy.
I have excellent Highmark Blue Cross/Blue Shield insurance.

Here is where my day/week/rest of life crumbled unpredictably.
At the counter.

I went to the store after work to pick up the Rx and was accosted by a visibly disturbed pharmacist who immediately started into me about how my Eliquis was costing them forty dollars per fill. My prescription bag had a big yellow page attached with STOP written in black.

We are at the check out counter and there are quite a number of workers in the background and customers behind me milling about.

She started ranting about how their store was losing money on this and that I needed to call my insurance about increasing their reimbursement. She went on and on but by this time my mental state had deteriorated severely from the flood of confusion, embarrassment, anger, and shock.

I finally interrupted her and asked if she did not want me to use their store to fill this medication.

She said yes.

When I checked out I may have muttered something equivalent to, " Kiss my ass. You don’t need my business."

And left the store promptly.

I researched this particular issue and found out that it is indeed legal and happens all the time.

I’ve never heard of it.

I advised people at work including my administrator and HR Director but I do not have the energy to pursue this right now. I am kind of just defeated.

Will transfer all of my prescriptions to Walmart and move on.

I can’t do mail order because I am never home due to working and traveling. That would just not work for me right now.

I was more annoyed at the way this pharmacist handled the interaction. Why didn’t they call or text me when the RX was initially called in?

Or at the very least take me to the back of the store or somewhere more private. This happened at the store counter in full view of all of the workers and customers behind me in line.

I still would have been angry but not embarrassed by a full on unpredictable in store skirmish. I will never walk in that store again except to take the elevator to my doctor’s office which is on the second floor (sigh).

2

Again it’s not about Eliquis; it’s about a huge number of brand name drugs vs small locally owned pharmacies who don’t have the negotiating power to get adequate reimbursements from insurance companies. So don’t be surprised if this pharmacy goes out of business within a few years–as a huge number of them have.

3

I understand the issue and its got a lot of factors involved. I know it is not about Eliquis but that is the drug I have personae experience with.

It came as a surprise and I needed to vent.

This local pharmacy has 7 stores in the county and has operated since the 1950s. They will not go out of business anytime soon.

4

The pharmacy business is a mess. Family owned single unit or small chain operators are getting squeezed out. Your employer doesn’t give a fig about whether this guy takes the pharmacy plan they provide you. If CVS or Walgreens or Walmart (or major regional chain) didn’t take it, they would change plans.

Basically all kinds of anti-competitive practices that would bring the FTC down on you like a ton of bricks in the food or auto business are tolerated in the pharmacy (and healthcare) business. I mean who the fuck even knows who the consumer is. The whole machinery certainly doesn’t see the end user (patient) as the customer.

Pharmacy is the part of the business where people vent their spleen because it LOOKS like a retail operation and you seem to be a customer. But it’s not. Your employer is the customer.

5

I have worked for companies over the last 37 years (since 1988) who have bought out literally hundreds of independent pharmacies over that time. The ones that survive are successful at selling NON prescription products, aka snake oil. Supplements, naturopathic and homeopathic remedies.

6

I’m sorry this happened to you. It was extremely unprofessional and yes, they should have called you and explained the situation. I wouldn’t ever go back either.

7

“You should get generic warfarin instead of Eliquis, to protect this pharmacy’s profit margin!”

Mmm, nope.

8

I, too, am sorry this happened to you, @Ellecram. The pharmacist was massively unprofessional.

I know this interaction caught you off guard, but should you ever find yourself in a similar situation, I’d recommend doing the following:

Say the word, “HIPAA!” in a very loud voice. Turn around and look the closest next-in-line person right in the eye and ask, “Is there anyone in this line who didn’t hear this pharmacist disclose my private health information?” Turn back to the pharmacist and say, “Would you like to continue violating HIPAA law and have me report you to your regulatory agency for doing so, or would you prefer to treat me with some common respect and decency as we conclude this interaction?”

20/20 hindsight, I know. :confused:

The pharmacist was completely out of line! What is wrong with people?

9

@Aspenglow
Oh yes that would have been a great response.

I was too clouded with turmoil to even think at that point.

Will keep this in mind for potential future interactions.

10

This pharmacy also has a health care supply business along with the 7 pharmacies. They have been a community fixture since before I was born.
But I do understand the dilemma and the whole system is broken in ways I’ve never encountered before.

11

I was on that particular medication in the early 1990s when I experienced DVTs and pulmonary embolisms from bunion surgery.

It was a nightmare. But I only has to be n it for 6 months.

Since I had a second episode in 2023 I now have to be on blood thinners for life.

12

I have stopped into the store occasionally as it’s basically the only place to get certain things in my small town except for the ubiquitous Dollar General.
But I will never darken their doorway again!

13

I know. :frowning: And I doubt that in the moment, I’d have had the presence of mind to do as I suggested, either. But at least you’ll be better prepared if it ever happens again! You did nothing wrong and in no way deserved the humiliation.

14

Thank you for that. It helped to type it out here as well as talk it over with a few friends.
My loins are now girded for future encounters. :smiling_face_with_sunglasses:

15

Just for the record, I take Apixaban (the generic name for Eliquis) and I just looked at the receipt. The pharmacist paid (all prices in CAD) $24 for 60 pills (5 mg) plus $1.56 to the wholesaler and their fee of $10.50, for a total of $36.06 of which insurance (from the province) paid $24.52 and I paid $11.54. I take it twice a day so that is a 30 day supply.

16

While what the pharmacist did was inexcusable, there’s no need to involve other customers. They just want to get their prescriptions and leave. And it’s unlikely that they’ll conclude that this loud, obnoxious customer, for which situation they have no context, is in the right here. They’re just going to conclude that there’s another Karen abusing the staff and yelling at other customers.

17

Did I say “yell”? I did not. I said “ask”. In no way did I suggest that other customers should be abused.

Most pharmacies have a sign at the window telling those in line to keep back in order to respect people’s privacy at the window. So those in line already know that private health information is supposed to remain between the pharmacist and the patient. I know if I heard a pharmacist discussing what was meant to be private in a voice loud enough to know the medication the person at the window was on, my first thought would be, do I want to risk my own PHI being loudly spread about in an effort to embarrass me?

And whether the other people in line felt that way or not, the pharmacist would presumably understand that they were violating HIPAA and the patient knows they are. Might have an effect on how they treat others going forward. That would be worth it to me to risk someone thinking I’m a “Karen”.

18

The italics on “didn’t” imply that you’re raising your voice, at least.

I’m in line behind you. I’m not listening to any of your transaction. Except suddenly I hear you say HIPAA loudly, and then you whirl around and hear you ask me something about private health information. I have no idea what you’re talking about and didn’t even understand the question, since again, I’m only interested in collecting my prescription, not hearing about some private dispute between you and the staff. I shrug and mutter uhhhhh…. And when it’s my turn I ask the pharmacist what was his/her problem?.

If you want to inform the staff that they’ve committed a HIPAA violation, involving other customers yourself probably isn’t the best way.

19

The reason I consider this an important part of the exchange is to establish that the pharmacist is already speaking in a voice loud enough to involve other patients. You say you’re not listening to any of my transaction, but based on the scenario outlined by the OP, is that true? Aren’t you already uncomfortably listening to the loud pharmacist complaining about the cost of my Eliquis prescription to the pharmacy?

I recognize this approach is far more confrontational than most people are comfortable with, but the work I do regards PHI as inviolate. I would want to remind the pharmacist of this. I’m sure it’s not an approach many would take, including you. But I would.

20

Maybe. But I tend to tune out things that aren’t directed at me personally, and you’re the one that involved me in the hypothetical. I’m certainly not disputing that the pharmacist was in the wrong. But if both parties have raised their voice in some dispute that doesn’t concern me, my main conclusion is that neither one is really acting in an adult fashion. Of course you should notify the pharmacist of the violation. Raising your voice and delaying the customers behind you is probably not the way to get them to take you seriously.